The Impacts of Drug Copayment Policy on Medical Utilization and Expenses for Epilepsy Patient in Taiwan
Date Issued
2004
Date
2004
Author(s)
Chen, Hou-Jen
DOI
zh-TW
Abstract
Bureau of National Health Insurance (NHI) implemented drug copayment policy on August 1, 1999. This new policy was designed to reduce the growth of ambulatory care expenditure and prescription utilization. This study aimed to evaluate the impact of drug copayment policy, and it used NHI claim data from 1998 to 2001 and tax report information with difference-in-difference methodology to analyze.
This study observed epilepsy patients’ medical utilization and health status for both short-term (i.e., one year after the policy) and long-term (i.e., two year after the policy) periods. Besides, it evaluated correction of “cure item” column in the NHI claim data by analyzing epilepsy patients.
The main findings were concluded as below:
1.The impacts of epilepsy patients’ medical utilization
and expenditure:
(1) Prescription expenditure:
There were no significant effects on total prescription
expenditure and antiepileptics expenditure for both short-
term and long-term periods.
(2) Prescription days:
There was a significant decrease on total prescription
days and antiepileptics days for both short-term and long-
term periods.
(3) Ambulatory care visits:
There was a significant decrease on total ambulatory care
visits and epilepsy-related ambulatory care visits for both
short-term and long-term periods.
2.Using length of stay and emergency care visits as health
status indicator, the impact of epilepsy patients' health
status:
(1) Length of stay:
There was no significant effect on total length of stay
for both short-term and long-term periods, and there was a
significant decrease on epilepsy- related length of stay.
(2) Emergency care visits:
There was no significant effect on total emergency care
visits and epilepsy-related emergency care visits for both
short-term and long-term periods.
3.By analyzing epilepsy patients’ medical utilization and
expenditure, this study found there were lots of data
missing in “cure item” column in NHI claim data.
Besides, there were lots of significant differences from
medical utilization and expenditure between patients who
had records in the column and those who did not have
records.
Based on above findings, this study suggests:
1.It is appropriate to maintain the current drug copayment
policy.
2.In order to release the financial burden for those
chronic patients who really need medical cares,govern-
ment should motivate doctors to prescribe more longer
duration of medicine for chronic diseases as incentive.
Meanwhile, government should encourage chronic patients
to discuss with doctors to know whether they should take
longer duration of medicine for chronic diseases or not.
3.In order to avoid more researchers will have been
confused by NHI claim data in the future, Bureau of NHI
should evaluate the existence of “cure item” column.
Subjects
特定治療項目代號
抗癲癇藥物
醫療費用
醫療利用
癲癇
健康狀況
健康保險
必要性藥品
部分負擔
健保資料庫
差異中之差異
Copayment
NHI claim data
Medical Utilization
Difference-in-difference
Essential drugs
Health status
Antiepileptics
Medical Expenditure
Epilepsy
Cure item
Health insurance
Type
thesis
File(s)![Thumbnail Image]()
Loading...
Name
ntu-93-R91843006-1.pdf
Size
23.31 KB
Format
Adobe PDF
Checksum
(MD5):8dae30e78920296295b8f84ca5178e87